Tests carried out on Ötzi, the prehistoric man found trapped in ice 5,300 years ago, have already revealed the presence of Lyme disease. Although the public health risks associated with tick bites are not directly related to agriculture, the subject cannot be ignored.
This report was inspired by personal experience; a long journey, countless negative test results and medical opinions led to the long-awaited diagnosis. After decades of doubt, a half-wasted childhood, bewilderment and vision problems of unknown origin, it seems that the truth is finally coming to light. And although this is not typically a winter topic, there are species of tick capable of seeking a host even in mild frost: we must never let our guard down, and it is best to be prepared for the warmer weather.
Lyme disease is not the only potential cause
Lyme disease is the best-known tick-borne illness. It is caused by various strains of the Borrelia burgdorferi sensu lato bacterial family (e.g. Borrelia burgdorferi, B. afzelii, etc.), which are found in large numbers in Hungary too. The classic symptom, widely recognised in the public consciousness and often regarded as ‘proof’ of the disease, is the redness at the site of the bite – sometimes resembling a bullseye – known as erythema migrans. In addition, fatigue, muscle and joint pain may also occur. But that is by no means all, says Dr Klára Esztó, a dermatologist, clinical immunologist and specialist in Lyme disease.
Lyme disease can usually be successfully treated with antibiotics if detected early, but
As a result, many people are unaware that a tick-borne disease is the cause of their symptoms, particularly if they did not even notice the bite.
Co-infections
According to Klára Esztó’s decades of experience, tick-borne infections often do not occur in isolation. The tick is a vector organism in which several pathogens can remain viable simultaneously, and it can transmit multiple infections during a single blood meal. Unfortunately, many people do not attach much importance to co-infections and question the medical knowledge surrounding them, explains the specialist. Alongside Lyme disease, there is increasing discussion of illnesses caused by Bartonella, and, more rarely, by the bacteria Anaplasma and Ehrlichia, as well as by the single-celled parasite Babesia. The latter is well known in veterinary medicine, as babesiosis in dogs can be a serious, even fatal, disease; however, ticks can also infect humans with the pathogen, and in very rare cases, it can cause illness in humans too.
If someone has a disease caused by Babesia, antibiotic treatment usually fails, as the pathogen is a single-celled organism, and often only anti-malarial drugs are truly effective against it. Klára Esztó explained that, in the worst-case scenario, as many as 7–8 infectious agents may be present in the patient’s body.
Why is diagnosis difficult?
One of the biggest problems with diseases spread by the common tick is the varied and often non-specific set of symptoms. Patients complain of fatigue, sleep disturbances, headaches, joint and muscle pain, and numbness, which are not infrequently accompanied by mental disturbances (and this is only a fraction of the symptoms). These infections often cause difficulty concentrating, memory problems, anxiety and even panic attacks.
Note: These symptoms can easily mislead both the patient and the treating doctor, as numerous other illnesses, and even psychological overload or stress, can cause similar symptoms. Conventional laboratory tests often fail to provide a clear answer, and the results of serological tests do not always accurately reflect the processes taking place within the body.
To avoid errors, tests in accordance with the differential diagnosis must always be carried out. Once these have been carried out and the clinical picture is characteristic, it is worth administering treatment ex juvantibus (based on the likelihood of the therapy’s success) in the hope of improving the patient’s condition. It sometimes happens that a person is serologically positive yet completely asymptomatic, whilst others suffer from severe symptoms despite having negative or inconclusive serological results. The state of the immune system, individual genetic predisposition and the combination of infections all play a decisive role in this. Klára Esztó emphasises: it is not the test result that needs to be treated, but the disease itself.
Why are farmers particularly affected?
Due to Hungary’s geographical features and wildlife, ticks are present across virtually the entire country, and of these, only the common tick (Ixodes ricinus) transmits these infections. Songbirds, small mammals, hedgehogs, lizards and outdoor pets also spread them, and milder winters, as well as climate change, favour their survival.
People working in agriculture, forestry and game management regularly spend time in habitats where these ticks are found in large numbers.
Key point: It is important to note that drug treatment does not provide immunity: anyone who has previously had Lyme disease or another tick-borne infection can become infected again and again.
Warning signs
According to the specialist, one of the most important warning signs is when someone feels unwell for a prolonged period and the cause of their symptoms cannot be clearly identified, even if all routine laboratory tests are negative. In such cases, it is worth considering the possibility of tick-borne diseases.
Prevention remains key: appropriate clothing, covering up, regular self-checks, and the prompt and proper removal of ticks. If symptoms persist, it is advisable to consult a specialist who is knowledgeable about the links between Lyme disease and co-infections.
The difficulties in eradicating pathogens
Unfortunately, the pathogens in question are extremely resistant. Bacteria employing ‘survival’ strategies may not be eradicated by standard therapy, says the specialist. Certain bacteria are capable of adopting survival strategies that are unaffected by antibiotics, he adds. There is ample evidence that, despite the treatments received, live pathogens can still be detected in animals. Czech researchers have now confirmed this in humans as well. It is a very interesting and exciting topic, but unfortunately there is no global consensus on treatment. According to the literature, the same debates are taking place in America.
Primarily, these include a person’s immune system and genetic characteristics, predispositions, as well as other infections or illnesses. Some people experience excruciating joint pain, whilst others may instead develop facial nerve paralysis. Of course, the range of symptoms also depends on where the pathogen is deposited when the tick feeds, but one thing is certain: based on the prevalence of infection among ticks, our country is considered endemic, which means infection is common; consequently, we must always bear this possibility in mind.
